This annotated bibliography provides a review of studies on exercise rehabilitation, psychological interventions, and medication adherence for patients with cardiac complications. It includes recommendations for clinical practice.
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Annotated Bibliography Name of the Student Name of the University Author Note
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Part 1 The aim of the study,Sagaret al.(2015) was toprovide a review of the services for exercise rehabilitation for people with cardiac problems like HF in Australia and to identify the potential organisational barriers in delivering these services.Itwas systematic review and meta-analysis of randomized controlled trials.A total of 33 trials were included with a total of 4740 participants predominantly. Each study has a control and upto a follow-up of 1 year. Standard sample size and long follow-up period can be considered as few of the strengths of the study. However, long follow-up period is associated with certain limitations like decrease in the sample size during the follow up session. The analysis of the results showed that the exercise reduced the risk of overall rate of hospitalization (RR 0.75; 0.62 to 0.92, 0.005) and hospitalization arising out of heart failure. Meta-regression analysis highlighted that these benefits were independent of the type and dosage of the exercise CR along with duration of the trial follow- up.The analysis of the results highlighted that promising improvements in decreasing the rate of hospitalization upon the cardiac patients under implementation of exercise regime for the cardiac rehabilitation. The reduction in the hospitalization was also reflected in the domain of cardiac-arrest related hospitalization. The result was independent of the dosage and duration of exercise. Jiang, Shorey, Seah, Chan, Tam and Wang (2018) conducted systematic review of the randomised control trails (2006 to 2016) and the aim was to study psychological interventions on the process of self-care and psychological and health outcomes in patients with chronic heart failure (CHF). A total of 29 articles were selected for the review. Selection of the articles from the last 10 years helped to increase the reliability and validity of the evidence based practice highlighted in the review. The analysis of the results highlighted that psychological interventions help to improve self-care among cardiac patients who are devoid of cognitive impairment and clinical depression. The results also revealed importance of 1
psychological interventions in improving health-related quality of life of the patients suffering from cardiac problems (combined MD −7.53, 95% CI −12.83 to −2.23). However, psychological intervention effect on reducing patients' level of anxiety level failed to show up statistically significant results. Authors concluded that implementation of the psychological interventions is helpful in improving the health-related quality of life of the patients suffering from the cardiac complications. However, the effect of the psychological intervention on anxiety level of the patients failed to fetch significant results. The study ofMolloyet al. (2012) aimedto provide a detailed knowledge about the evidence-based practice in improving the medication adherence of the patients suffering from the cardiac complications. The systematic review of the randomised control trial was selected for this study. The trials in which the intervention groups are compared with the placebo group were selected for the study. The main population of interest were the adults (>18 years). Sixteen independent studies were finally selected for the trials. However, this can be regarded as a limitation of the study as 16 is a very small sample size. The analysis of the results highlighted that the main pharmacological interventions that are successful in increasing the therapy adherence among the cardiac patients include patient education and simplification of the drug regime. However, simplification of the drug regime failed to provide significance as the selected studies failed to provide the desired rationale against the importance of the simplification of the drug regime.The study concluded theimportance of the patient education in increasing the therapy adherence. For the patient’s education person- centred care plan was proposed such that the educational plan for patient’s education must be designed based on behavioural needs of the patient 2
Running head: ANNOTATED BIBLIOGRAPHY Part 2 The study ofSagaret al.(2015)was selected because its provide evidences behind the importance of the physical exercise in improving the overall health-related quality of life of the patients suffering from cardiac complications. The authors selected randomized control trials with a six months of follow and thus helped to gain an unbiased result. The review highlighted that application of the physical exercise regime helps to decrease the rate of hospitalization irrespective of the duration and the dosage of exercise. According toMenezes et al. (2014), the older adults who are over-weight and have previous reported history of cardiac complication are more vulnerable towards cardiac complications. The case study highlighted that William, 75 years old, is over-weight and wasdiagnosed with chronic heart failure because of ischemic cardiomyopathy and hypertension in 2017. Thus regular practice of the physical exercise will not only help to reduce his body mass index but will also help to reduce the risk of developed cardiac complication in the immediate future (Sagar et al., 2017). The study conducted by showed regular practice of mild to moderate physical exercise helps to helps in the effective management of the hyper-tension. Miller, Mandrusiak and Adsett (2018) highlighted in their review the physical exercise helps to improve health- related quality of life of the patients. Thus, regular practice of physical exercise for Williams will improve his physical fitness, health-related quality of life along with reduction in the rate of hospitalisation due to cardiac complication. The review conducted by Jiang et al. (2018) was selected because it helps to get a detailed insight about how psychological intervention helps to improve the quality of life of patients.Cukor et al. (2014) stated that mental well-being have a profound influence over the physical well-being of individuals. A person who is mentally fit and happy is more likely to 3
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ANNOTATED BIBLIOGRAPHY abide by healthy lifestyle process and thereby decrease the threat of the cardiac arrest among the patients who have previous history of cardio-vascular disease. William has a history of hypertension and he has been experiencing distressing shortness of breath for the past few- days. However, he only sought for medical help when the conditions were severe like visible peripheral oedema. This revealed that there is a lack of self-care in and suggest implementation of the psychological interventions in increasing the tendency of self-care for William. Saleh et al. (2014) stated that psychological interventions also help to improve the medication adherence. Psychological intervention improves medication adherence by improving the quality of life of the older adults. Livingston et al. (2014) conducted a system review, stated that psychological interventions are clinical effective, and at the same time is cost-effective. Effective implementation of the psychological interventions helps to reduce agitation among the older adults. Decrease in agitation not only increase mental health status but also helps to reduce hypertension and thereby reducing the threat of developing cardio- vascular disease. The study of Molloy et al. (2012) was selected because it showed that education of the patient in the domain of the disease awareness helps to increase the therapy adherence among the patients.Murphy et al. (2014) stated thata majority of the patient’s population fails to adhere to the cardiovascular medications adequately. Prevalence of the optimal adherence is identical across all the patients’ population in the cardiovascular medications. The level of optimal adherence of cardiovascular disease medication confers a potential inverse association with the subsequent adverse outcomes of the disease like peripheral oedema. In order to enhance medication adherence and to reduce the potentials of cardiac therapies under the clinical setting, patients’education and awareness are proved to be effective. In case of William, the level of medication adherence must be poor leading to relapse of the disease. Thus educating the patient about the disease and the process of disease prognosis might be 4
ANNOTATED BIBLIOGRAPHY helpful in increasing therapy adherence and improvement in lifestyle habits.Bansilal, Castellano & Fuster (2015) stated that burden of cardiovascular disease is high among the older adults such as Williams. Education and awareness will help to increase the therapy adherence. The education and awareness can be given through community based health education program and by the help of group-based interaction. Such discussion, lectures and interactions help to increase awareness among the older adults such as Williams. 5
ANNOTATED BIBLIOGRAPHY Part 3 The recommendation for the clinical practice includes recruitment of the home based personal clinical training for assistance and training of the regular physical activity in order to promote weight loss. Weight loss can also be promoted through proper education. Therefore, educating Williams about dietary guidelines like low intake of cholesterol cardiovascular disease is important. Under the clinical practice change, it is recommended to provide person- centred care plan for the patient for managing of his cardio-vascular conditions. The person- centred care plan for Williams will entails giving periodic reminders about medication intake and providing proper dietary guidelines based on his height, weight, body mass, age and nutritional requirement. Proper dietary habits will help to manage his escalating weight (Berger et al., 2015). He must be educated about the disease prognosis and severity of peripheral oedema and how it is related to his liver. The disease awareness will help to promote the tendency of self-care. Education must be under the supervision of the community health nurse (Jiang et al., 2018). From the case study it is not clear that whether William stays alone or resides with his friends or family. If he stays alone then he must be immediately shifted to residential care settings. Under the residential care settings, proper assistance from the residential nurses will help to improve the therapy adherence for Williams(Kogan, Wilber & Mosqueda, 2016). 6
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ANNOTATED BIBLIOGRAPHY References Bansilal, S., Castellano, J. M., &Fuster, V. (2015). Global burden of CVD: focus on secondary prevention of cardiovascular disease.International journal of cardiology,201, S1-S7.https://doi.org/10.1016/S0167-5273(15)31026-3 Berger, S., Raman, G., Vishwanathan, R., Jacques, P. F., & Johnson, E. J. (2015).Dietary cholesterol and cardiovascular disease: a systematic review and meta-analysis.The American journal of clinical nutrition,102(2), 276- 294.https://doi.org/10.3945/ajcn.114.100305 Cukor, D., Ver Halen, N., Asher, D. R., Coplan, J. D., Weedon, J., Wyka, K. E., ... & Kimmel, P. L. (2014). Psychosocial intervention improves depression, quality of life, and fluid adherence in hemodialysis.Journal of the American Society of Nephrology,25(1), 196-206. DOI: https://doi.org/10.1681/ASN.2012111134 Jiang, Y., Shorey, S., Seah, B., Chan, W. X., Tam, W. W. S., & Wang, W. (2018).The effectiveness of psychological interventions on self-care, psychological and health outcomes in patients with chronic heart failure—A systematic review and meta- analysis.International Journal of Nursing Studies,78, 16-25. doi:10.1016/j.ijnurstu.2017.08.006 Kogan, A. C., Wilber, K., &Mosqueda, L. (2016).Person‐centered care for older adults with chronic conditions and functional impairment: A systematic literature review.Journal of the American Geriatrics Society,64(1), e1-e7.https://doi.org/10.1111/jgs.13873 Livingston, G., Kelly, L., Lewis-Holmes, E., Baio, G., Morris, S., Patel, N., ...& Cooper, C. (2014). A systematic review of the clinical effectiveness and cost-effectiveness of sensory, psychological and behavioural interventions for managing agitation in older 7
ANNOTATED BIBLIOGRAPHY adults with dementia.Health technology assessment (Winchester, England),18(39), 1.doi:10.3310/hta18390 Menezes, A. R., Lavie, C. J., Forman, D. E., Arena, R., Milani, R. V., & Franklin, B. A. (2014). Cardiac rehabilitation in the elderly.Progress in cardiovascular diseases,57(2), 152-159.https://doi.org/10.1016/j.pcad.2014.01.002 Miller, S., Mandrusiak, A., &Adsett, J. (2018). Getting to the Heart of the Matter: What is the Landscape of Exercise Rehabilitation for People With Heart Failure in Australia?Heart, Lung & Circulation,27(11), 1350–1356.https://doi- org.libraryproxy.griffith.edu.au/10.1016/j.hlc.2017.08.016 Molloy, G. J.,O'Carroll, R. E.,Witham, M. D.,&McMurdo, M.E. T. (2012). Interventions to enhance adherence to medications in patients with heart failure: A systematic review. Circulation Heart Failure, 5, 126- 133.http://dx.doi.org/10.1161/CIRCHEARTFAILURE.111.964569 Murphy, G. K., McAlister, F. A., Weir, D. L., Tjosvold, L., &Eurich, D. T. (2014).Cardiovascular medication utilization and adherence among adults living in rural and urban areas: a systematic review and meta-analysis.BMC Public Health,14(1), 544.https://doi.org/10.1186/1471-2458-14-544 Sagar, V. A., Davies, E. J., Briscoe, S., Coates, A. J. S., Dalal, H. M., Lough, F., … Taylor, R. S. (2015). Exercise-based rehabilitation for heart failure: Systematic review and meta-analysis.Open Heart, 2, 1-12. Retrieved from http://openheart.bmj.com/content/openhrt/2/1/e000163.full.pdf Saleh, F., Mumu, S. J., Ara, F., Hafez, M. A., & Ali, L. (2014). Non-adherence to self-care practices & medication and health related quality of life among patients with type 2 8
ANNOTATED BIBLIOGRAPHY diabetes: a cross-sectional study.BMC public health,14(1), 431.https://doi.org/10.1186/1471-2458-14-431 9